Verification Of Parent Illinois Residency - Chicago State University
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1Office of Student Financial Aid | 9501 S. King Dr., ADM 207 | Chicago, IL 60628-1598 | Ph: 773.995.2304 | Fax: 773.995.3574 |E-mail:
csu-finaid@csu.edu
2016-2017 VERIFICATION OF PARENT ILLINOIS RESIDENCY
The Illinois Student Assistance Commission (ISAC) requires that in order for a dependent student to be eligible for the
Monetary Award Program (MAP) the parent whose information is required to be included on the student’s Free
Application for Federal Student Aid (FAFSA) must be a resident of the State of Illinois. It is Chicago State University’s
responsibility to ensure that all MAP recipients meet this ISAC requirement. For a dependent student to be
considered an Illinois resident: the parent of the dependent student must physically reside in Illinois and Illinois
must be his/her true, fixed, and permanent home. Students who are in a graduate or post-baccalaureate program
are not eligible for MAP.
S
I
(
):
TUDENT
NFORMATION
PLEASE PRINT CLEARLY
__________________________________________________
_____________________________________
Student Last Name
First Name
M.I.
CSU Identification Number
_______________________________________________________________________________________________________
Street Address
City
State
Zip Code
Parent’s state of legal residence is Illinois:
Yes
No (If no, please indicate your state of legal residence here _________
and skip the Illinois Residency Documentation section. Sign and date this form and submit to the Office of Student Financial Aid.)
Parent Illinois Residency Confirmation: Dependent students’ parent(s) are required to submit documentation certifying they
are a resident of the state of Illinois.
Please indicate the month and year your parent began residing in Illinois __________/__________
Month
Year
ILLINOIS RESIDENCY DOCUMENTATION
PLEASE COMPLETE THIS FORM IN ITS ENTIRETY. INCLUDE STUDENT’S NAME AND CSU ID NUMBER ON ALL ATTACHED DOCUMENTS.
You may drop off, mail, fax or scan and e-mail required documentation. Our address, fax number and e-mail address are listed at
the top of this form.
Submit only one item, listed below, to verify Illinois residency. Please check the box identifying the documentation you are
attaching to verify Illinois residency:
2015 W2 forms
IL Driver’s License
IL State Identification Card
State of IL Taxes
IL Auto Registration Card
2015 Federal Tax Return Transcripts
IL Voter Registration Card
IL Property Tax Bill
IL Public Aid: Statement of Benefits
IL Department of Employment Security: Statement of Benefits
Parent’s Utility Bill or Lease
Other (subject to approval/acceptance by the Fin. Aid office)
Student and Parent Signature: I certify that the information provided on this form, and any attachments, is true and correct.
________________________________________________________
_______________________________________
Student Signature
Date
________________________________________________________
_______________________________________
Parent Signature
Date
________________________________________________________
Parent Printed Name
2016-2017 VERIFICATION OF PARENT ILLINOIS RESIDENCY (updated 02/29/16)
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